Regional Core Health Data Initiative
- 1. Regional Core Health Data Initiative Andrea Gerger Health Analysis and Information Project, PAHO/HSD/HA Regional Advisory Committee on Health Statistics Meeting Havana, Cuba, 26-28 March 2012
- 2. Regional Core Health Data Initiative • a standard information platform on the health situation and trends in the countries of the Region of the Americas • a collective effort • ‘Collection and Use of Core Health Data’ • Cross Organizational Team (COT) on Core Data and Country Profiles
- 3. Regional Core Data Initiative Demand Information Axes Products •Geographic Information System (GIS) •Basic Indicators Brochure •PAHO Strategic Plan •Table Generator Management •BWP for Countries & HQ HEALTH •RHO and Strategic Planning •Health Agenda for the Americas CORE •Long term planning DATA •Programming, M&E of Technical Technical Cooperation activities Country Profiles Cooperation at Country Offices and HQ •Health in the Americas •Annual Report •PAHO Epidemiological Bulletin Resource Mobilization •Preparation of Projects REFERENCE DOCUMENTS •Technical Information •Mandates & Goals Information Dissemination •Public Information •Norms & Standards •Methodological Tools
- 4. Goals • Technical cooperation – mandates • Define policies and strategies • M&E • Monitor health situation and health systems performance • Collect, analyze, disseminate information
- 5. Data base description: main variables, time series and admin level • PAHO Basic Health Indicator Database – 114 indicators for 48 countries/territories + definitions – Admin level: country – Time series: 1995 - present – categories: • Demographic, by sex • Socioeconomic • Mortality, by sex • Morbidity and risk factors • Access, resources and coverage
- 6. Sources RCHDI indicadores fuentes demográficos estimaciones NNUU y Oficina del Censo de EUA socioeconomicos estimaciones Banco Mundial, FAO, UNESCO mortalidad base de datos de mortalidad de cada país morbilidad datos del pais vía programa técnico de la OPS recursos, acceso, cobertura datos del país vía programa técnico de la OPS
- 7. Online data entry - Countries
- 8. Online data Entry – PAHO Projects
- 10. New requested indicators • Hypertension prevalence • Diabetes mellitus prevalence • Under-five mortality • Proportion of hospital deliveries • Prenatal care, minimum 4 visits
- 11. Mortality Rates • Countries with observed mortality: Chile, Canada, USA, Mexico, Costa Rica, Cuba, Puerto Rico, Argentina, Barbados, Grenada, Montserrat, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago, UK and US Virgin Islands • Countries with corrected mortality: Belize, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Dominica n Republic, Colombia, Ecuador, Peru, Venezuela, Brazil, Paraguay , Uruguay, Anguilla * Antigua & Barbuda, Aruba, Bahamas, Dominica, Cayman Islands, Guyana, Jamaica, Suriname, Turks and Caicos
- 13. Country Health Profiles • To analyze relevant and strategic health information for informed decision-making in public health • To generate knowledge of the health status of countries and contribute to decision-making processes at both national and international level • Cross-sectional descriptive and time series analysis of strategic health indicators • To facilitate the evaluation by country of the extent of coverage and quality of health information analyzed and to provide impetus for its improvement.
- 14. Maternal Mortality Ratio / 100 000 lb reported to PAHO
- 15. Infant Mortality Rate / 1 000 lb reported to PAHO
- 16. Birth Information System • Birth database of the Americas, started 2009 • Data exploration phase • Standardization of variables, quality and coverage • Generate indicators based from birth databases (low birth weight, prenatal visits, % of c-section, maternal age,…) • Analysis & Dissemination
- 17. PAHO birth database - 2010 Mother Newborn Birth Residence of mother Sex Date of birth Civil status Weight Place of birth Age Gestational age Gestational age Prenatal visits Education level Place of delivery Ethnicity/race Type of delivery Prenatal visits
- 18. Birth Data Availability • Analisis de disponibilidad aquí? Aquí • Pueda estar con fatima o aqui
- 19. Main data quality problems • Availability • Definitions and interpretations • Sources: data between countries/within are from different sources: survey, administrative registry, estimates • Coverage: Data do not cover all sectors • Under-registration: e.g. low birth- weight, births, deaths, infant and maternal deaths • Inconsistency (e.g. IMR, MMR, U5M)
- 20. Challenges • Data quality • Uncoordinated data requests to countries (duplicated, not integrated) • Increased data collection efforts within PAHO • Missing instance to coordinate
- 21. 2012-2013 agenda • New RCDHI strategy to Directing Council 2013 • COT support (renewed key indicators) • Basic Indicators guide • Databases redesign and management • Technical cooperation focus on data quality
- 22. Mortality Indicator Review- RCHDI
- 23. Purpose of mortality indicators at PAHO hqs • Study relevant and strategic data for decision- making in public health based on evidence in the countries • Assist managers, health professionals, population in general to access principal cause of death and know the regional profile, compare with other countries, evolution in time, coverage and quality
- 24. RCHDI mortality indicators CORE TIME DATA DESAGGREGATION LEVELS DATA MORTALITY INDICATORS INTERVAL by by NEW CODE REFERENCE by age sex AND Total sex group age group C.10.0.9 Annual proportion of under-5 registered deaths due to acute diarrheal diseases (ADD) by year Y C.11.0.9 Annual proportion of under-5 registered deaths due to acute respiratory infections (ARI) by year Y C.13 Overall mortality (all causes) (1,000 pop) by 3-year period/single year Y M; F G1 G1 C.15 Mortality due to communicable diseases by 3-year period/single year Y M; F G1 G1 C.16 Mortality due to tuberculosis by 3-year period/single year Y M; F C.17 Mortality due to HIV/AIDS by year Y M; F C.19 Mortality due to diseases of the circulatory system by 3-year period/single year Y M; F G1 G1 C.20 Mortality due to ischemic heart disease by 3-year period/single year Y M; F G2 G2 C.21 Mortality due to cerebrovascular disease by 3-year period/single year Y M; F G2 G2 C.23 Mortality due to neoplasms (tumors), all type by 3-year period/single year Y M; F G1 G1 C.25 Mortality due to malignant neoplasms (tumors), all type by 3-year period/single year Y M; F G1 G1 C.26 Mortality due to malignant neoplasms of the lung, trachea, and bronchus by 3-year period/single year Y M; F G2 G2 C.49 Mortality due to malignant neoplasms of cervix uteri by 3-year period/single year Y F G3 G3 C.50 Mortality due to malignant neoplasms of corpus uteri by 3-year period/single year Y F G3 G3 C.51 Mortality due to malignant neoplasms of uteri, unspecified parts by 3-year period/single year Y F G3 G3 C.28 Mortality due to malignant neoplasms of the female breast by 3-year period/single year Y F G3 G3 C.29 Mortality due to malignant neoplasms of the digestive organs and peritoneum by 3-year period/single year Y M; F G2 G2 C.31 Mortality due to external causes by 3-year period/single year Y M; F G1 G1 C.32 Mortality due to accidents, excluding transport accidents by 3-year period/single year Y M; F G4 G4 C.33 Mortality due to all transport accidents by 3-year period/single year Y M; F G4 G4 C.38 Mortality due to land transport accidents by 3-year period/single year Y M; F G4 G4 C.43 Mortality due to motor vehicle traffic accidents by 3-year period/single year Y M; F G4 G4 C.34 Mortality due to suicide and self-inflicted injuries by 3-year period/single year Y M; F C.35 Mortality due to homicide by 3-year period/single year Y M; F C.36 Mortality due to cirrhosis and cronic liver disease by 3-year period/single year Y M; F G3 G3 C.37 Mortality due to diabetes mellitus by 3-year period/single year Y M; F G2 G2 G1 G2 G3 G4 OTHER INDICATORS: <1 yo 45-64 yo 35-44 yo <15 yo Proportion of death underregistration (by 3-year period) 1-4 yo 65+ yo 45-64 yo 15+ yo 5-14 yo 65+ yo Proportion of registered deaths due to symptoms, signs, and ill-defined conditions Rate Ratio homicide mortality male:female (by 3-year period) 15-44 yo Male homicide rate, corrected (by 3-year period) 45-64 yo 65+ yo
- 25. Age-groups G1 G2 G3 G4 <1 yo 45-64 yo 35-44 yo <15 yo 1-4 yo 65+ yo 45-64 yo 15+ yo 5-14 yo 65+ yo 15-44 yo 45-64 yo 65+ yo
- 26. Indicators and ICD-10 codes CORE DATA MORTALITY INDICATORS ICD-10 CODES NEW CODE C.10.0.9 Annual proportion of under-5 registered deaths due to acute diarrheal diseases (ADD) A00-A09 C.11.0.9 Annual proportion of under-5 registered deaths due to acute respiratory infections (ARI) J00-J22 C.13 Overall mortality (all causes) (1,000 pop) all causes A00-Y89 C.15 Mortality due to communicable diseases A00-B99,G00-G03,J00-J22 C.16 Mortality due to tuberculosis A15-A19 C.17 Mortality due to HIV/AIDS B20-B24 C.19 Mortality due to diseases of the circulatory system I00-I99 C.20 Mortality due to ischemic heart disease I20-I25 C.21 Mortality due to cerebrovascular disease I60-I69 C.23 Mortality due to neoplasms (tumors), all type C00-D48 C.25 Mortality due to malignant neoplasms (tumors), all type C00-C97 C.26 Mortality due to malignant neoplasms of the lung, trachea, and bronchus C33-C34 C.49 Mortality due to malignant neoplasms of cervix uteri C53 C.50 Mortality due to malignant neoplasms of corpus uteri C54 C.51 Mortality due to malignant neoplasms of uteri, unspecified parts C55 C.28 Mortality due to malignant neoplasms of the female breast C50 C.29 Mortality due to malignant neoplasms of the digestive organs and peritoneum C15-C26,C48 C.31 Mortality due to external causes V01-Y89 C.32 Mortality due to accidents, excluding transport accidents W00-X59 C.33 Mortality due to all transport accidents V01-V99 C.38 Mortality due to land transport accidents V01-V89 V02-V04(.1-.9), V09.2,V09.3,V12-V14(.3- .6), V19(.4-.6),V20-V28(.3-.9), V29-V78(.4- .9),V80(.3-.5), V81.1,V82.1,V83-V86(.0-.3), C.43 Mortality due to motor vehicle traffic accidents V87(.0-.8),V89.2,V89.9 C.34 Mortality due to suicide and self-inflicted injuries X60-X84 C.35 Mortality due to homicide X85-Y09 C.36 Mortality due to cirrhosis and cronic liver disease K70,K73,K74,K76 C.37 Mortality due to diabetes mellitus E10-E14
- 27. Group Work • One hour group work: define rapporteur • Each group: 10 minutes to report back
- 28. Questions • Analyze the relevance of current cause of death data • Analyze the relevance of current age-groups • Recommend the inclusion/exclusion of cause of death data and age-groups
- 29. • Group 1 – infectious diseases: Eartha Groenfelt, Cassia Buchalla, Paul Ricketts, Affette McCawBinns, Sarah Quesnel, Carolina Danovaro, Aiza Gauna, Juan Eugenio Hernandez • Group 2 – chronic diseases: Rafael Lozano, Gerardo Martinez, Bastiaan Van’t Hoff, Danuta Rajs, J Chique, Aline Jimenez, Magda Ruiz, Eduardo Zacca • Group 3 – external causes: Beatriz Plaza, Lina Sofia Palacios, Elida Marconi, Ana Nogales, Luis Manuel Torres, Heloisa DiNubila, Josette Iribedra, Miguel Angel Martinez
- 30. Group Work • One hour group work • 10 minutes to report back
Editor's Notes
- #2: Why RCHDI, what, how
- #4: Próposito continua acutalizada
- #5: Recomendar a los Estados Miembros:a) que utilicen un conjunto básico de información en salud para orientar laformulación, el ajuste y la evaluación de políticas y programas sanitarios, asícomo sustentar la reorientación de los servicios de salud y el fortalecimiento delos sistemas de vigilancia en salud pública;b) que renueven su compromiso con la recopilación oportuna de datos sobre lasituación de salud y bienestar, asegurando su validez y la cobertura de todos losgrupos humanos, desglosando la información por niveles geográficos, sexo ygrupos poblacionales de interés para la salud y el desarrollo humano nacional;c) que utilicen los datos básicos en salud como fuente principal para la medicióncuantitativa y la comparación de prácticas en cuanto al logro de metas desituación de salud fijadas por mandatos nacionales e internacionales.3. Pedir al Director:a) que siga apoyando el desarrollo de la iniciativa de datos básicos en salud comoelemento fundamental del mandato de la OPS consistente en facilitar a los EstadosMiembros información sanitaria regional de la más alta calidad y relevancia;b) que establezca mecanismos de coordinación con otros organismos y agenciasinternacionales que solicitan esta información, con el fin de lograr la máximacoherencia de los datos presentados por las mismas.
- #6: How many of each block? 12, 12, 33, 30 , 21 = 104Complete, valid, internally consistent (disaggregation: male and female is total) and temporal consistency
- #10: Coberturavalidosconsistenciainterna
- #18: EstandarizarPromover e institucionalizar el registro y certificación de los nacimientos